Experts Warn of Impending Medicaid Gap

Tuesday

Feb 12, 2013 at 7:17 AM

FORT LAUDERDALE | Experts warned Florida lawmakers Monday that if they do not expand Medicaid, it will create a coverage gap for those who earn too little to qualify for tax credits to buy insurance from the online exchange but too much to qualify for Medicaid.

By KELLI KENNEDYThe Associated Press

FORT LAUDERDALE | Experts warned Florida lawmakers Monday that if they do not expand Medicaid, it will create a coverage gap for those who earn too little to qualify for tax credits to buy insurance from the online exchange but too much to qualify for Medicaid.

The decision also would keep Florida from receiving billions of federal dollars to help pay for those health costs while heaping greater burdens on hospitals treating the uninsured.

Republican Gov. Rick Scott and GOP lawmakers have warned that Medicaid coverage to about 3 million of the state's poorest is costing the state about $21 billion a year and must be reined in. Scott also is worried that the cost of expanding Medicaid coverage to an estimated 900,000 more residents under the Affordable Care Act is too high for Florida taxpayers.

But several experts stressed that the residents who will become eligible for Medicaid under the federal health overhaul will be paid for by the federal government at a much higher rate than those who currently are covered under an approximately 50 percent matching rate. The Obama administration will pick up 100 percent of cost for first three years if a state expands Medicaid and 90 percent after that.

Even if the state chooses not to expand Medicaid eligibility levels, the publicity will likely increase enrollment for those who are eligible. The state would have to contribute more than seven times more for an already eligible person than for a newly eligible person over a 10-year period, Greg Mellowe, director of Health Research and Analysis, Florida Center for Fiscal and Economic Policy , noted at a committee hearing in Tallahassee.

It's unclear how many people might fall under that category. Conservatives warn that people will come out of the woodwork to apply for health coverage and that states will not be able to afford it.

Committee Chair Sen. Joe Negron noted that Arizona enrollment was more than twice what state officials estimated when the state expanded health coverage to childless adults.

Georgetown University Health Policy Institute Research Associate Professor Joan Alker agreed there is a "pent up demand" from some uninsured patients with pre-existing conditions and other factors keeping them from getting insurance that will likely cause some type of uptick in enrollment.

But she said the federal government will foot the entire bill for those enrollees initially under the expansion and enrollment likely will lessen in future years when states are paying a higher share.

Mellowe also noted no federal health program, including Medicare, enrolls 100 percent of those who are eligible.

Experts said it's important for states to expand Medicaid so they can draw on the additional federal dollars to offset the costs of those who may enroll under current reimbursement rates.